Procrit and Aranesp for aplastic anemia

Is aranesp considered medically necessary for aplastic anemia?

Erythropoietin levels are elevated in apalstic anemia patients. This raises the probability that additional exogenous erythropoietin may not be effective. However, despite the same concern, erythropoietin is effective in  in myelodysplastic syndrome. I reference a Japanese editorial that advocated the use of erythropoietin ( and this would include darbepoetin) for aplastic anemia.

However, there is very little supporting literature and no recommendations that are based on credible studies. Some experts do not support erytropoietin therapy in apalstic anemia. A noted authority, Dr. Jerry L. Spivak said this: "Myelofibrosis, leukemia, and aplastic anemia are other situations where erythropoietin therapy is usually ineffective, and when infection or inflammation is sufficiently severe, the response to erythropoietin will be blunted.", at http://www.anemia.org/professionals/asktheexpert/treatment.jsp

My conclusion is that darbepoietin is investigational and not medically necessary in aplastic anemia.



http://www.journalarchive.jst.go.jp/english/jnlabstract_en.php?cdjournal=internalmedicine1992&cdvol=37&noissue=3&startpage=235

V. Pavlovic-Kentera

Erythropoietin in aplastic anemia Annals Hematology

Volume 39, Number 5 / November, 1979

M Bessho, I Jinnai, A Matsuda, M Saito and K Hirashima

Improvement of anemia by recombinant erythropoietin in patients with myelodysplastic syndromes and aplastic anemia International Journal of Cell Cloning, Vol 8, 445-458, Copyright © 1990 by AlphaMed Press